there's been a huge amount of press lately (by this I mean at least the last five years) about how our medical system is set up so that it rewards expensive treatments with big machines and not preventative medicine, like lifestyle changes, screening techniques, and other early interventions to diseases and disorders that later become difficult if not impossible to cure (eg diabetes, breast cancer, heart disease, MIs). The US Medicare Advising Committee (Medpac) just released a brief discussing this problem - emphasizing that less medical graduates are going into primary care careers because their work in other fields is viewed as more important and rewarded accordingly. However, the action recommended for this critical problem is only: "The Commission should review and discuss draft recommendations".
And what about the recommendations by physicians in this article in the Journal of the American Medical Association a few weeks ago? They included emphasizing more collaboration by an entire health care team - including Nurse Practitioners and Case Workers. Whatever the recommendations the Commission comes up with, I hope they include both collaboration and a reward system that allows doctors to keep people healthy and focuses on screening, education, and early intervention.
And, American Medical Association, doesn't it also make sense to decrease the price of medical schools, so new doctors don't graduate in so much debt that it's impossible for them to ignore the financial incentives of specialty fields.